October Issue 2009

Pakistan has the highest rate of breast cancer deaths for any Asian population, accounting for 40,000 deaths per year. Approximately 90,000 cases of breast cancer are diagnosed every year, but the number of unreported cases is expected to be much more.

Societal and cultural mores, combined with poor access to rural healthcare for women, limit the public health education information available on breast cancer and discourage both public and private discussion, advice, early discovery and treatment among women. In the conservative society of Pakistan, one of the provinces has even banned male doctors from treating female patients and as such one cannot dare to talk or say anything about female breasts.

In a first for Pakistan, and any Islamic country, the Women’s Empowerment Group addressed these issues head-on by launching and establishing a nationwide Breast Cancer Awareness Campaign. The main objectives of the campaign were to make breast cancer an acceptable topic of discussion in the public domain, create widespread awareness about it, promote the practice of self-diagnosis and evoke empathy in the right quarters to support the cause. Using this strategic, multi-pronged approach, decision-makers and government officials were targeted in the first phase of the campaign. This strategic move was followed by a mass awareness drive at the grassroots level with Pink Ribbon Pakistan’s long-term vision of reducing breast cancer mortality in the country.

National and international celebrities were contacted to support the campaign. In 2006, Cherie Blair, the wife of former British prime minister Tony Blair, was invited to Pakistan and she advocated fighting against the disease in her meetings with elected representatives, government officials, medical practitioners and the media. The campaign also managed to gain support from then first lady of Pakistan, Sehba Musharraf.

In order to form a public-private partnership, Memorandums of Understanding (MoUs) have been signed with the federal and provincial ministries of women development to include information about breast cancer in reproductive health packages and to allow for the duty-free import of the necessary drugs, testing and therapy. A chapter on self examination has been added in the training manual of lady health workers and the establishment of a cancer registry in the country has also been initiated. Strategic alliances have also been developed with renowned teaching hospitals and health-related institutions to expand the scope of the campaign and to maximise its outreach through medical structures that are already in place.

Modern trends have shown that young girls in their early twenties are increasingly being diagnosed with breast cancer. Therefore, the Youth Awareness Programme (YAP) has been launched to reach 300,000 girls through 300 colleges and universities across the country through a series of seminars and awareness camps. The YAP is providing knowledge through leaflets and posters in both English and Urdu, followed by a series of seminars and lectures by specialist doctors. Through this programme, young women are being informed about self-examination and early diagnostic methods. These young girls are also being used to influence their mothers and other women in their families to pass on the message. Simultaneously, the outreach of the campaign is being increased by networking with women’s groups.

Pink Ribbon Pakistan is a non-funded, self-sustained campaign, driven by a large number of volunteers all over the country. The ownership of the campaign by the volunteers and their innovative ways of reaching the target population has given a sharp boost to the campaign within a short span of time and has become a reason for its tremendous success.

This multi-pronged strategy has helped Pink Ribbon Pakistan to bring the awareness level from -100 (non-tolerant level) of government, media and the masses to zero (neutral base) within a period of five years. A subject which was taboo and very sensitive for an Islamic country like Pakistan, has now been brought up in the national agenda. The success of the campaign is evident from the fact that not only has the general public accepted the reality and dangers, the concerned institutions have also come forward to support Pink Ribbon Pakistan on this vital issue. According to the cancer division of Pakistan Atomic Energy Commission, the number of women coming to breast cancer clinics has increased since 2003, since the launch of Pink Ribbon Pakistan. However, the gravity of the situation still requires more focused, concentrated and systematic approaches to address the issue of the increasing incidence of breast cancer in the country. The realisation that breast cancer can be cured serves as a hope for a reduction in the mortality rate associated with it, and Pink Ribbon Pakistan aims to disseminate this hope to the maximum number of women in the shortest possible time.

This article appeared as a sidebar in a bigger story in the October 2009 issue of Newsline: The Reality of Breast Cancer.